Veterans Benefits - Health Care

The Department of Veterans Affairs (VA) provides health care benefits, including hospital care, outpatient care, and nursing home care to eligible veterans. Generally speaking, services are provided on a priority basis.

Enrollment

Because the availability of VA health care benefits may be limited by congressional appropriations, most veterans must enroll to receive those services. The VA then determines whether each veteran will be required to make a copayment for services. In general, veterans whose disabilities are not service connected or whose disabilities are rated as 0%, with a net worth above a certain threshold, must make copayments. Those with service-connected disabilities and those with net worths below the governmental threshold receive first priority.

Only three types of veterans need not enroll: (1) veterans with service-connected disabilities rated at 50% or more disabling; (2) veterans who have been discharged during the last year due to a compensable disability; and (3) veterans seeking care for a service-connected disability.

Hospital And Outpatient Care

These services are provided on a priority basis to veterans. Veterans with no copayment are served first, followed by veterans who make copayments. The latter must pay a small daily copayment for hospital care. Additionally, during the first 90 days of each 365-day period in the hospital, they must pay the Medicare deductible. After the first 90 days, however, they need only pay one-half of the Medicare deductible. Copayment veterans must also pay a percentage of an average outpatient visit for outpatient care.

Nursing Home Care

A priority system is also used to determine eligibility for nursing home care in both VA nursing homes and in nursing homes under contract with the VA to provide care. As with hospital and outpatient care, veterans with no copayment are served first.

Veterans with service-connected disabilities rated at 70% who require long-term nursing care are eligible to receive such care at VA expense indefinitely. In practice, however, those veterans usually stay in VA hospitals rather than nursing homes.

Veterans whose disabilities are not service connected are only eligible for short-term nursing care at VA expense.